The Effect Of Isolated Eccentric Isokinetic Exercises Versus Concentric-Eccentric Isokinetic Exercises Of Ankle Plantar Flexor Muscles In Chronic Mid-Portion Achilles Tendinopathy

Objective To determine which mothod is better by comparing the isolated eccentric isokinetic exercise of ankle plantar muscles with concentric-eccentric isokinetic exercise of this muscle group so that we can optimize the physical therapy program of the chronic mid-portion Achilles tendinopathy,and therefore enhance the treatment efficiency of this disease.Methods Sixty patients who had unilateral,chronic mid-portion Achilles tendinopathy were randomly divided into two groups,both of which contained thirty patients.Both groups were routinely provided some interventions of rehabilitation for twelve weeks after enrolled,while the eccentric group were instructed to undertake the isolated eccentric isokinetic exercises of the ankle plantar flexor muscles of the affected sides and the other one,concentric-eccentric group,were instructed to undertake the combined concentric-eccentric isokinetic exercises of this muscle group of the affected sides with the Biodex dynamometer training system three times per week.The scores of VAS,OLHT and VISA-A of the two groups were measured at the beginning of rehabilitation and after the twelve weeks.All of these results were collected to analyze with statistics method.Results Generaldata in age,gender and time from the disease beginned to the first assessment between the two groups were no significant difference(P>0.05).1.VAS scoe:After the rehabilitation for twelve weeks,the VAS scores of the two groups were decreased,of which the difference was statistically significant(P<0.05)And the score of the eccentric group was lower than that of the concentric-eccentric group(P<0.05).2.One-leg hopping test:After the rehabilitation for twelve weeks,the one leg hopping distance of the two groups were increased,of which the difference was statistically significant(P<0.05).Besides,the one leg hopping distance of the concentric-eccentric group was greater than that of the eccentric group(P<0.05).3.VISA-A score:After the rehabilitation for twelve weeks,the VISA-A scores of the two groups were increased,of which the difference was statistically significant(P<0.05).Furthermore,the score of the eccentric group was higher than that of the concentric-eccentric group(P<0.05).Conclusion 1.From the aspect of pain relief and function improvement,the effect of isolated eccentric isokinetic exercises of ankle plantar flexors is greater than that of concentric-eccentric isokinetic exercises.From the aspect of muscle performance improvement,however,the effect of concentric-eccentric isokinetic exercises of ankle plantar flexors is greater than that of isolated eccentric isokinetic exercises.2.It is considerable that the isolated eccentric isokinetic exercises are instructed at the earlier stage and the combined concentric-eccentric isokinetic exercises are instructed at the later stage of mid-portion Achilles tendinopathy.